Provider Demographics
NPI:1477106763
Name:FLEMING, JEFFREY (MSW)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:FLEMING
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 SHERWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1852
Mailing Address - Country:US
Mailing Address - Phone:517-337-1663
Mailing Address - Fax:
Practice Address - Street 1:3475 BELLE CHASE WAY
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4252
Practice Address - Country:US
Practice Address - Phone:517-882-3732
Practice Address - Fax:517-882-3732
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011135611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical